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Home My WebLink About12-29-09 5056051058 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN PO BOX 280601 21 09 0405 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Socal Security Number Date of Death Date of Birth 169-26-9559 ' 03/29/2009 ' 11/02/1935 Decedent's Last Name Suffix Decedent's First Name MI Weida Sr. Paul (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Weida ' Gloria Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW 1. Original Return 2. Supplemental Return 3. Remainder Retum (date of death prior to 12-13-82) 4. Limited Estate 4a. Future Interest Compromise (date of 5. Federal Estate Tax Return Required death after 12-12-82) • 6. Decedent Died Testate 7. Decedent Maintained a Living Trust Q 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) _. 9. Litigation Proceeds Received s::.:.~'a 10. Spousal Poverty Credit (date of death 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number Tricia D. Naylor Firm Name (If Applicable) REGISTER OF VYI~S..USE ONLY Law Office of Tricia D. Naylor VV ?~ -v ~ T -~ ' , ' First line of address -' ~ r- r c'? r ; 104 S. Hanover Street ~ ~->~~=`~-' ~ ~-, r:: - ~ ~ Second line of address ' :3 ~ 'TJ `- ~` C:;~ - -._.I W f ` --~- ~) ' TI City or Post Office State ZIP Code DATILED ~ c, ~ ,-~y Carlisle PA 17013 (V ~f'~ Correspondent's a-mail address: tnaylOf@CarBSlepalaw.COm Under penalties of perjury, I declare that 1 have examined this return, including accompanying schedules and statements, and to the hest of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PE SON RESPONSIB~FOR FILING RETURN DATE ~~ 133 . Lo er _ - -_. iIG E OF PR ~DDRE S 104 .Hanover .isle, HAN REPRESENTATIVE Ca 'sle, PA 17013 DATE ONLY 15056051058 Side 1 15056051058 ~~ J REV-1500 EX 15056052059 Paul Weida Decedent's Name: RECAPITULATION 1. Real estate (Schedule A) . ...................................... ..... 1. 2. Stocks and Bonds (Schedule 6) 2. 3. Closely Held Corporation. Partnership or Sole-Proprietorship (Schedule C) .... 3 4. Mortgages & Notes Receivable (Schedule D) ............... • • • . • • • • ~ • • • • • 4• 5. Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) ........ 5. 6. Jointly Owned Property (Schedule F) Separate Billing Requested ....... 6. 7. Inter-Vivos Transfers & Miscellaneous Non-PSepa aterBieng Requested........ 7 (Schedule G) 8. Total Gross Assets (total Lines 1-7) .................................... 8. 9. Funeral Expenses 8 Administrative Costs (Schedule H) .. .................. 9. Decedent's Social Security Number 169-26-9559 76.92 13,425.47 10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule I) .............. .. 10. 11. Total Deductions (total Lines 9 & 10) ................................. .. 11. 12. Net Value of Estate (Line 8 minus Line 11) ......... ..... .... 12. 13 Charitable and Governmental BequestslSec 9113 Trusts for which . an election to tax has not been made (Schedule J) .. 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) ...................... .. 14. TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 13 521.18 15. , (a)(1.2) X .0_ 16. Amount of Line 14 taxable 23,898.30 at lineal rate X .0 45 16. 17. Amount of Line 14 taxable 17 at sibling rate X .12 18. Amount of Line l4 taxable 6,535.46 18 at collateral rate X .15 19. TAX DUE ............................................... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 37,419.48 50,921.87 3,622.95 3,343.98 6,966.93 43,954.94 43,954.94 0.00 1,075.42 980.32 2,055.74 15056052059 Side2 15056052059 REV-1500 EX Page 3 Decedent's Complete Address: 21 Paul Weida STREET ADDRESS 133 W. High Street CITY Carlisle File Number 09 0405 DECEDENT'S SOCIAL SECURITY NUMBER 169-26-9559 STATE ZIP PA 17013 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) 2,055.74 2. CreditslPayments A. Spousal Poverty Credit ------- -- ---- _---- . -- -- -- __ B. Prior Payments 2,750.00 C. Discount 102.79 Total Credits (A + B + C) (2) 2,852.79 3. InteresUPenalty if applicable D. Interest E. Penalty Total InterestlPenalty (D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. (4) 797.05 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (56) Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes ^ No a. retain the use or income of the property transferred :................................................................................... ...... ^ b. retain the right to designate who shall use the property transferred or its income : ...................................... ...... ^ c. retain a reversionary interest; or .................................................................................................................... ...... ^ d. receive the promise for life of either payments, benefits or care? ................................................................ ...... 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death ^ without receiving adequate consideration? ....................................................................................................... ....... ^ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ....... ....... 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which ^ contains a beneficiary designation? .............................:................................................................................... ....... ® IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [72 P.S. §9116 (a) (1.1) (i}J. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. §9116(1.2) (72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1503 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Paul Weida, Sr. SCHEDULE B STOCKS & BONDS FILE NUMBER 21-09-0405 eu nrnnarty lointlv.ewned with right of survivorship must be disclosed on Scneaule r. (If more space is needed, insert additional sheets of the same size) REV-1508 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Paul Weida, Sr. SCHEDt~LE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY Include the proceeds of litigation and the date the proceeds were received by the estate. All property jolntlyowned with right of survivorship must be disclosed on Schedule F. ITEM JMBER DESCRIPTION 1. M8T Bank Certificate of Deposit #31003917741231 2. Accrued Interest on Item 1 3. M&T Bank Checking Account #1303090 4. M&T Bank Savings Account #15004212116188 5. Accrued Interest on Item 4 6. Refund of rental security deposit 7. Refund of 2008 Federal Income Tax 8. Refund of Cancer Care insurance premium 9. 2008 PA Property TaxlRent Rebate 10. Refund of insurance premium from Capital Blue Cross 11. Refund of insurance premium from Affinion Group 12. Misc. personal property TOTAL (Also enter on line 5, Recapitulation) 5 (If more space is needed, insert additional sheets of the same size) FILE NUMBER 21-09-0405 VALUE AT DATE OF DEATH 5,216.98 5.26 1,233.15 5,101.46 0.04 375.00 300.00 15.18 650.00 95.00 25.30 408.10 13,425.47 RSV-1510 EX! ;03-0)) `~ pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS AND MISC. NON-PROBATE PROPERTY FILE NUMBER ESTATE OF 21-09-0405 Paul Weida, Sr. This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV•1500 is yes. DESCRIPTION OF PROPERTY DATE OF DEATH % OF DECD'S EXCLUSION ITEM NUMBER INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE GATE OF TRANSFER. ATTACH A COPY OF THE DEED f0R REAL ESTATE. VALUE OF ASSET INTEREST ;IF APPLICABLE] I. Western & Southern Life Annuity #W0020601863 transferred to 13,521.18 100 Glorida Weida, wife of decedent Westem & Southern Life Annuity #W0020194199 transferred to 11,583.00 100 2 Harry Weida, son of decedent Westem & Southern Life Annuity #W0020696228 transferred to 12,315.30 100 3 Paul Weida, Jr.m, son of decedent TOTAL (Also enter on Line 7, Recapitulation) $ If more space is needed, use addltiona! sheets of paper of the same size. TAXABLE VALUE 13,521.18 11,583.00 12,315.30 37,419.48 R=V~ 1511 Ei(+ 10-097 "~ Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF Paul Weida, Sr. FILE NUMBER 21-09-0405 Decedent's debts must be reported on Schedule I. ITEM NUMBER A. FUNERAL EXPENSES: 1. AM g. ADMINISTRATIVE COSTS: I. Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City State ZIP Year(s) Commission Paid: 3,250.00 2. Attorney Fees: 3. family Exemption: (if decedent's address is not the same as claimant's, attach explanation.) Claimant Street Address City __ __.__ .__ State __. ZIP ___ __ Relationship of Claimant to Decedent 140.00 4. Probate Fees: 5. Accountant Fees: 6. Tax Return Preparer Fees: ~• Legal Advertising- Cumberland Law Journal 75.00 a. Legal Advertising- The Sentinel 113.20 s. Bank Charge /Estate Checks - Orrstown Bank 29'75 15.00 ~o. Inheritance Tax Filing TOTAL (Also enter on Line 9, Recapitulation) I ~ 3,622.95 If more space is needed, use additional sheets of paper of the same size. RFV-ISli F..X+ ii-;181 Pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Paul Weida Sr. 21-09-0405 ..___s .,_~..:...,...aa ti., .tie ee~odp~r nrinr r~ death that remained unpaid at the date of death, including unreimbursed medical expenses. If more space is needed, insert additional sheets of the same size. R ~ ~ `. ... ; ~7 r' Y i ~ pennsylvania i SCHEDULE J DEPARTMENT OF REVENUF. BENEFICIARIES INHERITANCE iAX RETURN RESIDENT DECEDENT FILE NUMBER ESTATE OF 21 -09-0405 Paul Weida, Sr. RELATIONSHIP TO DECEDENT AMOUNT OR SHARE 7 c NAME ANO ADDRESS OF PERSON(S) RECEIV.NG PROP._RTv Da Not List Trustee(s) OF ESTATE NUMBER I TAXABLE DISTRIBUTIONS [Include outright spousal distr~uut~sos and !~ars'ers Under ~ Sec, 9116 (a}'1.2 ] 1.1. Gloria Weida 1 wife 13,521.18 Reed Street 89 Chaddsford, PA 19317 2. Paul Weida, Jr. son 12,315.30 89 Reed Street, Chaddsford, PA 19317 3. Harry Weida ~ E 19810 son 11,583.00 719 Renner Rd., 1 Wilmington, D 4. Meichelle Trent friend 6,535.46 133 E. Louther St., Carlisle, PA 170 3 ;i ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV•1500 COVER SHEET, AS APPROPRIATE. II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX i5 NOT TAKEN 1. B. CHARTABLE AND GOVERNMENTAL DISTR]BUTIONS 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. I $ if more space is needed, insert additional sheets of the same size.